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Counseling and clinical psychology is the area that tends to develop and adopt new approaches to treating patients. The dynamic social environment, research achievements, and practical efforts lead to a more sophisticated system used by psychologists, which creates the need to thoroughly synthesize and evaluate related changes. This paper focuses on discussing the available scholarly literature on assessment, prevention, and clinical work trends in psychological research.
The psychological assessment is one of the key activities conducted by professionals by collecting patient data and making corresponding decisions. Borders et al. (2014) mention that regardless of a specific setting, the majority of psychologists refer to observation and interview as a means of obtaining information to be evaluated. The first assessment direction is personality and cognitive functioning testing that can include Bender-Gestalt, Wechsler Adult Intelligence Scale III, and so on. Clinical specialists use neuropsychological functioning assessment more frequently compared to their counseling colleagues, which is caused by the differences in their patients. Among the latest trends, the self-administering and self-scoring assessment approach may be noted as the one that provides patients with credible information about their personality (Borders et al., 2014). The assessments applied by counseling and clinical experts may vary, depending on a patient setting, health problem, and cultural peculiarities.
Cultural-clinical psychology emphasizes the cultural variation that is identified not only by group culture but also by individual perceptions of a person. The trend is that the mentioned psychology aims to critically assess a patient’s identity without being excessively concentrated on his or her connections to one or another culture (Ryder, Ban, & Chentsova-Dutton, 2011). For example, in a family where parents belong to different nationalities, their cultural views tend to be blended, and, therefore, a psychologist should not consider that a Hispanic mother is impulsive only because of her background. In other words, there is a link between culture and a person, and both of them affect each other.
The collaboration between integrated and cultural psychology is the critical tendency in the field. Ryder et al. (2011) suggest that they are likely to compose one specialty that requires altering both of them so that they can be used by specialists as a holistic approach to patient treatment. In particular, the main challenge is associated with considering mental disorders from the cultural perspective: for example, depressive symptoms should be evaluated with regard to emotional constructs and how people view them on an artistic level. In its turn, cultural psychology has excellent potential to assist clinical psychology in conceptualizing disorders and selecting the best strategies. As a result, the integrated contribution of the mentioned psychology directions is likely to advance assessment practices and lead to more effective and high-quality care services.
The suitability of clinical assessments for various patients refers to the notion of equivalence. It means that all individuals should be assessed with a full range of available tools, while their cultural peculiarities are to lead this process. For instance, facial coding, interviews, and open-ended response coding may compose the instruments of a psychologist working in terms of cultural-clinical psychology. In order to enhance the positive impact of this approach, Ryder et al. (2011) recommend studying the limits of cultural influence on a person and his or her environment. It is stressed that the cultural aspect is often neglected in clinical and counseling psychology, and the increase in awareness of diversity and cultural competence are likely to essentially improve assessment effectiveness and patient outcomes.
Technical eclecticism is a model and introduced by psychologists who operate as eclectic specialists. Prescriptive eclectic psychotherapy is one of the most known perspectives that represent the abovementioned theory, providing the semantic instructions and blending various methodologies in terms of language and dialect learning (Norcross, Karpiak, & Lister, 2005). It is important to emphasize that contrary to other integration means. Technical eclecticism does not involve theoretical understanding. Compared to technical eclecticism, the assimilative integration implies the selection of a single method and its further supplementation by other relevant therapeutic approaches. The psychodynamic theory may be noted as the vivid representative of the assimilative integration since the former allows for tracking patient progress and assessing it via, for example, homework tasks (Cutts, 2011). The theoretical integration is distinguished by its focus on incorporating several concepts of different theories selected for a particular patient.
Speaking of the historical context of the integration means discussed earlier, one should state that technical eclecticism was elaborated by Lazurus, while Beutler provided another model within this framework, which was designed to strengthen the ability of a specialist to choose the most suitable strategy (Norcross et al., 2015). The key advantages of this perspective are individualized therapy, high engagement, and the consideration of a problem from different angles. However, the need to have a skilled psychologist, the potentially confusing nature of the change of treatment methods, and overutilization are its disadvantages.
The historical background of the theoretical interaction is the need to discover new combinations of models and strategies to improve care quality. Wachtel’s model of cyclical psychodynamics and Ryle’s model of cognitive analytic therapy are the two most prominent examples (Cutts, 2011). The applicability of the theoretical integration to all approaches, empathy to patients, and wide theoretical basis compose the core advantages. The fact that the main goal was not achieved yet targeted and difficulties with using all the points of a range of theories are also disadvantages.
With regard to the assimilative integration perspective, Schafer and Gill may be noted as those who were first to identify the need for counselors to refer to more than one theory in their practice (Zarbo, Tasca, Cattafi, & Compare, 2016). The positive aspects include an emphasis on mindfulness, cognitive-behavioral principles, and the inclusion of experience and background in implementing theories. It should also be stressed that only skilled psychologists with sufficient knowledge may use it, and assimilative integration needs a firm grounding in one view. At the same time, this perspective is patient-dependent, which means that some errors may occur and are to be addressed in the course of counseling (Wachtel, 2018). Personally, it seems that this perspective aligns with my view on integration more than others. Since the critical idea of assimilation is to pay attention to backroad and experience, it is likely to provide better patient outcomes, involving other theories if necessary.
The blending of therapeutic relationships and techniques is the core trend in psychotherapy integration. The link between patients and psychologists is regarded as the issue that directly affects the positive outcome of their joint work on the given problem (Wachtel, 2018). The development of these relationships is one of the critical areas prioritized by counseling and clinical psychology. Another trend refers to the amalgamation of theoretical foundations, which is expected to improve understanding of problems encountered by patients and facilitate their recovery (Gorenstein & Comer, 2015). Cognitive-behavioral therapy (CBT), for example, may act as the basis to be complemented by other theories. The principles of CBT are beneficial to apply to diverse patients and cultural backgrounds.
The emphasis on the specific situation as a way to comprehend a patient’s condition is one of the most important trends in today’s psychology. By assessing one’s context and taken into account such personality features as acceptance and consciousness and the whole specter of emotions, the counselors can have better access to a person’s experience (Wachtel, 2018). The second trend is associated with evce-based practices (EBP) that inform specialists’ decision-making and problem-solving activities. Holt et al. (2015) state that the EBP implies the use of the empirically verified results of recent studies to diagnose and treat patients, regarding them as individuals who need specialized care. Psychotherapy integration and EBP in combination present the incorporation of the best research and clinical expertise. The connection between these issues makes a patient the key active participant of the treatment process, who is to share preferences and culture with a clinician (Holt et al., 2015). In other words, EBP helps to organize and maintain integrative psychology while making theoretical foundations closer to practice.
Prevention is an important area of work in counseling and clinical psychology, which proposes strategies to avoid mental complications and disease development in many cases. There is a range of scholarly studies that point to guidelines formulated by both official healthcare organizations and individual researchers, as reported by Wachtel (2018). It is possible to distinguish between micro, meso, Exo, and macro levels of preventative measures. At the micro-level, a person or a family targeted by a care specialist may use such strategy as the consideration of ethical and contextual issues of their clients. As suggested by the American Psychological Association (2014), psychologists are expected to adhere to the national standards in promoting positive behaviors, being culturally competent. For example, an informed consent form is one of the ways to ensure that an individual clearly understands what exactly will be done for his or her health.
The meso level is characteristic of focusing on communities as an object of prevention. The call for systemic change interventions is one of the appropriate strategies to prevent social distress and achieve higher social inclusion. Inequality, poverty, racism, and other social barriers should be addressed in terms of this recommendation (American Psychological Association, 2014). Another opportunity is closely associated with the community-based collaboration with the engagement of clients and other interested stakeholders. The interprofessional cooperation of care providers is also likely to demonstrate valuable prevention results. The assumption regarding the importance of elicitation research is mentioned by Hage et al. (2017). This recommendation states that the study on the elements signified by group members should be conducted during the preventative intervention development.
Exo-level prevention refers to factors that affect a patient indirectly on the micro-level. The environmental and social factors may, for example, involve a child whose parents were to lose their jobs and become unemployed for an extended period. Continuous education and training are offered by Rivera-Mosquera, Dowd, and Mitchell-Blanks (2007). In their study, the mentioned authors claim that the ability of psychologists to reveal early signs of mental disorders at this level is essential to prevent further deterioration. The social work on justice, equality, as well as advocacy are the three components of the described recommendation.
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At the macro-level of the preventative activity, a nation, society, and civilization are to be covered. The deliberation and promotion of public policies are identified by the American Psychological Association (2014) as paramount to turn people’s attention to prevention needs. One should clarify that the above recommendation may be implemented on local and global levels by informing policymakers of problems and equipping them with relevant information and resources to make changes in laws and regulations. One more statement that can be applied at all levels is the elaboration and introduction of interventions that affect the reduction of risks and strengthening people’s health (American Psychological Association, 2014). The efforts towards the amelioration of social conditions are one of the specific actions that can be taken. The critical point is that the identified recommendations may be implemented in combination or separately depending on the situation.
In conclusion, this paper provided the literature review on the trends existing in clinical and counseling psychology. Cultural-clinical psychology was discussed as the primary assessment tendency, which is a comprehensive method to better understand a client’s emotional and psychological problems. In terms of clinical work, the nature, benefits, and drawbacks of technical eclecticism, theoretical integration, and assimilative integration were discussed. The prevention recommendations included diversity awareness, contextual analysis, advocacy, and social work.
American Psychological Association. (2014). Guidelines for prevention in psychology. American Psychologist, 69(3), 285-296. doi:10.1037/a0034569
Borders, L. D., Glosoff, H. L., Welfare, L. E., Hays, D. G., DeKruyf, L., Fernando, D. M., & Page, B. (2014). Best practices in clinical supervision: Evolution of a counseling specialty. The Clinical Supervisor, 33(1), 26-44. doi:10.1080/07325223.2014.905225
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Gorenstein, E. E., & Comer, R. J. (2015). Case studies in abnormal psychology (2nd ed.). New York, NY: Worth Publishers.
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Wachtel, P. L. (2018). Pathways to progress for integrative psychotherapy: Perspectives on practice and research. Journal of Psychotherapy Integration, 28(2), 202-212. doi:10.1037/int0000089
Zarbo, C., Tasca, G. A., Cattafi, F., & Compare, A. (2016). Integrative psychotherapy works. Frontiers in Psychology, 6, 1-3. doi:10.3389/fpsyg.2015.02021